Healthcare Provider Details

I. General information

NPI: 1497412993
Provider Name (Legal Business Name): LAURA L RAMIREZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 DEER PARK AVE
BABYLON NY
11702-2313
US

IV. Provider business mailing address

105 TRUXTON RD
DIX HILLS NY
11746-6827
US

V. Phone/Fax

Practice location:
  • Phone: 917-592-8445
  • Fax:
Mailing address:
  • Phone: 917-592-8445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number732209-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberF348171-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: